Trandolapril + Verapamil - Oral

Trandolapril and Verapamil are combined in this medicine.

Trandolapril + Verapamil helps to keep your blood pressure under control.

Take Trandolapril + Verapamil exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Take this medicine together with food or immediately after a meal. Try to take it at the same time each day.

Trandolapril + Verapamil is available as an extended-release type of tablet. Swallow it whole with a glass of water. Do not chew or crush the tablet.

This medicine must be taken regularly for it to be effective. Continue taking Trandolapril + Verapamil even when you feel better. Do not stop taking it unless instructed by the doctor.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor and pharmacist know.

Alert your doctor if you have the following conditions:

• personal or family history of angioedema (swelling of the deep layers of the skin usually around the face, throat, and lips)
• history of angioedema after receiving treatment containing similar medicines such as captopril
• severe heart failure (weakness and inability of the heart to pump blood)
• severely low blood pressure
• cardiogenic shock (a serious sudden condition when the heart cannot supply enough oxygen-rich blood to the brain and vital organs of the body)
• sick sinus syndrome (abnormal heart rhythms due to problems with your heart's natural pacemaker) without the presence of a functioning pacemaker (device implanted in the chest that helps control your heartbeat)
• 2nd- or 3rd-degree heart block without the presence of a functioning pacemaker
• abnormal heart rhythm disorder that affects the atria (upper chambers of the heart)

as Trandolapril + Verapamil may not be suitable for you.

Do not take this medicine if you are pregnant or planning to have a baby soon. If you become pregnant while being treated with Trandolapril + Verapamil, alert your doctor immediately. This medicine may cause harm to your unborn child. You must use proven birth control methods while taking Trandolapril + Verapamil.

Do not take Trandolapril + Verapamil with aliskiren (medicine for high blood pressure) if you have diabetes and kidney disease.

Do not take this medicine if you are currently taking or have taken sacubitril/valsartan (medicine for heart failure) in the last 36 hours.

Do not also take Trandolapril + Verapamil with flibanserin (medicine for decreased libido or low sex drive in premenopausal women).

Inform your doctor if you have the following conditions:

• other heart problems e.g. abnormally thick heart muscle, narrowing of heart valves
• disease of the blood vessels supplying the brain
• narrowing of certain blood vessels that carry blood to the kidneys
• low volume of circulating fluids in the body
• diabetes
• systemic lupus erythematosus (autoimmune disease that causes inflammation of certain organs in the body)
• Duchenne muscular dystrophy (a rare inherited disorder causing progressive muscle weakness and degeneration)
• myasthenia gravis (muscle weakness disorder)
• kidney disease
• liver disease

Let your doctor know if you are breastfeeding.

If you are of a Black race, Trandolapril + Verapamil may be less effective. Inform your doctor if you are taking this medicine.

If you are going to have a major operation and other treatment or procedures (e.g. a treatment that trains your immune system to be less sensitive to wasp or bee stings, LDL apheresis [a nonsurgical therapy that removes bad cholesterol in the blood], or dialysis [a procedure that helps individuals with kidney failure to filter toxic substances from the blood] with high flux membranes), inform your doctor that you are Trandolapril + Verapamil.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

• Routine tests (e.g. kidney function, electrolyte levels, complete blood counts) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
• Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.

What lifestyle changes can I make to improve my blood pressure?

Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.

If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.

Trandolapril + Verapamil hydrochloride may cause any of the following side effects: dizziness, headache, nausea, constipation, diarrhoea, weakness, flushing, back pain, and cough.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:

• rashes, breathlessness, swelling of the face, eyes, mouth, tongue, or throat
• yellowing of the skin and whites of the eyes, abdominal pain, dark coloured urine, tiredness, swelling in the legs and ankles
• severe dizziness or passing out
• persistent cough
• muscle weakness, cramping or numbness; fast or irregular heartbeat
• unusual bleeding or bruising, frequent sore throat, mouth sores, fever, chills or sweating
• pain or difficulty in passing urine, change in how much urine is passed, blood in the urine

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Trandolapril + Verapamil with aliskiren (medicine for high blood pressure) if you have diabetes and kidney disease.

Do not take this medicine if you are currently taking or have taken sacubitril/valsartan (medicine for heart failure) in the last 36 hours.

Do not also take Trandolapril + Verapamil with flibanserin (medicine for decreased libido or low sex drive in premenopausal women).

Inform your doctor and pharmacist if you are taking or using any of these medicines:

• medicines used in organ transplants or certain immune disorders e.g. sirolimus, everolimus, temsirolimus, ciclosporin
• medicines for heart failure e.g. digoxin, ivabradine
• medicines for epilepsy (fits or seizures) e.g. carbamazepine, phenobarbital, phenytoin
• medicines for diabetes e.g. insulin, metformin
• blood-thinning medicines e.g. heparin, dabigatran
• certain antibiotics e.g. trimethoprim/sulfamethoxazole, erythromycin
• NSAIDs (medicines for pain and inflammation) e.g. aspirin, ibuprofen, celecoxib
• water pills or medicines for water retention e.g. hydrochlorothiazide, amiloride, spironolactone, triamterene
• cholesterol-lowering medicines e.g. atorvastatin, simvastatin
• other medicines for high blood pressure e.g. atenolol, propranolol, prazosin
• lithium (medicine for mood disorders)
• racecadotril (medicine to treat diarrhoea)
• rifampicin (medicine to treat TB, a lung infection known as tuberculosis)
• cimetidine (medicine that reduces stomach acid production)
• ritonavir (medicine for HIV infection)
• theophylline (asthma medicine)
• quinidine (medicine for irregular heartbeat)
• potassium supplements or potassium-containing salt substitutes
• St. John's wort (herbal medicine)

This list does not include all medicines that may interact with Trandolapril + Verapamil.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).

Cut down on your salt intake. This may help lower your blood pressure and improve your overall health. Discuss with your doctor or dietitian about ways to cut down on your salt intake.

Do not take potassium supplements or salt substitutes that contain potassium.

Avoid taking too much food that is high in potassium, such as orange juice, bananas, or prunes.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.